Blood Sugar And Keto: Fluctuations And Facts

The ketogenic diet is a popular eating plan that has been around for years. It has gained traction recently due to its association with weight loss and other health benefits. The keto diet involves consuming very few carbohydrates, which deprives the body of glucose, a primary energy source. This forces the body to enter a state called ketogenesis, where it burns fat for energy instead. While this can be beneficial for weight loss and managing blood sugar levels, it is important to understand how blood sugar levels can fluctuate on a keto diet.

Ketosis and blood glucose

Blood glucose, or blood sugar, is a measurement of the amount of sugar circulating in your blood. When you eat food, your blood sugar will rise and fall—the more carbohydrates you eat, the more your blood sugar will spike. This is a normal process, but higher than normal blood glucose levels can be dangerous, increasing the risk of diabetes and heart disease.

Ketosis is a metabolic state that can only be achieved when the body is deprived of carbohydrates. When you're eating a ketogenic diet, your blood sugar is regulated thanks to such a low daily carbohydrate intake.

Blood glucose does not indicate whether you're in ketosis, but it can be correlated with the ketone levels in your body. It's also an indicator of your insulin sensitivity, or lack thereof.

Ketones and glucose are interconnected. As glucose rises, ketones fall, and vice versa. But blood sugar responds more quickly to the introduction of foods than ketones do, which is why measuring glucose on a ketogenic diet is so important.

According to the Mayo Clinic, a fasting blood sugar level under 100 milligrams per deciliter is healthy. Your blood sugar following food (even ingesting pure sugar) should not exceed 125 milligrams per deciliter, as this is a sign of prediabetes.

Blood glucose monitors are easy to find and relatively affordable. They provide a relatively immediate picture of how your body is responding to specific foods, meals, and activities. You can also use a continuous glucose monitor, which monitors glucose continuously and will help cut through the noise and variables.

Tips for managing blood glucose

• Exercise: Physical activity increases insulin sensitivity, the opposite of insulin resistance.
• Fasting: Nothing lowers blood glucose and insulin levels like not eating.
• The keto diet: The ketogenic diet severely limits carbs, helping to minimize the blood sugar response.
• Measure your blood glucose: Knowing how blood sugar fluctuates with different foods helps you make smarter choices.
• Spice and supplement: Spice your food with turmeric and cinnamon, or consider supplementing berberine, to limit your blood sugar response.
• Sleep well: Sleep is crucial for insulin function.

Insulin resistance

Under normal circumstances, insulin helps facilitate the entry of glucose into cells, where it is used for energy or stored for later use. When insulin resistance occurs, the cells do not efficiently take up glucose from the blood, resulting in elevated blood glucose levels. In response, the pancreas produces more insulin, leading to a condition called hyperinsulinemia.

The primary risk factors for insulin resistance include excess body fat, particularly around the belly, and a lack of physical activity. Other contributing factors include age, certain medications, hormonal disorders, and genetic conditions.

The treatment for insulin resistance focuses on lifestyle modifications, such as adopting a healthy diet, increasing physical activity, and losing excess weight. These changes can improve insulin sensitivity, lower blood glucose levels, and reduce the risk of developing prediabetes and Type 2 diabetes.

While there are no specific tests for insulin resistance, it can be diagnosed through a combination of physical examination, blood tests, and an individual's medical history.

Fasting blood glucose

When you eat a meal, your blood sugar rises, and the hormone insulin comes along to move that blood sugar out of your blood and safely into cells. Insulin keeps your blood vessels safe from the dangers of hyperglycemia and too-high blood sugar levels.

However, when sugar consistently enters the body, insulin can become overworked and unable to do its job. This is called insulin resistance and is the inability of insulin to effectively store blood sugar in muscle and liver cells. In a state of insulin resistance, blood sugar stays too high for too long, and this is how Type 2 Diabetes starts.

The keto diet can help to manage blood sugar levels. The ketogenic diet severely limits carbs, helping to minimise the blood sugar response. When glucose availability drops so low that the body doesn't have enough to use for energy, it enters a state called ketogenesis. In this state, ketone bodies are created from fatty acids and replace glucose as the body's primary source of energy.

According to the Mayo Clinic, a fasting blood sugar level under 100 milligrams per decilitre is healthy. Your blood sugar following food (even ingesting pure sugar) should not exceed 125 milligrams per decilitre, as this is a sign of prediabetes.

Optimal fasting blood sugar ranges are likely between 70 mg/dL and 85 mg/dL (3.9 and 4.7 mmol/L). Higher, and diabetes risk goes up. Lower, and you risk a low blood sugar state called hypoglycaemia.

Blood sugar and exercise

Exercise is a crucial factor in managing blood sugar levels and can be particularly beneficial when incorporated into a keto diet. Here's how blood sugar and exercise are interconnected and how you can use exercise to your advantage when following a keto diet.

The Impact of Exercise on Blood Sugar

Physical activity plays a significant role in regulating blood sugar levels. When you engage in exercise, your body's insulin sensitivity increases, which is the opposite of insulin resistance. This means that exercise helps your body use insulin more effectively to lower blood sugar levels. Both endurance exercises and weight training have been shown to have positive effects in this regard.

Additionally, the amount and intensity of exercise can affect blood sugar levels. Generally, the more intense and prolonged the exercise, the greater the impact on blood sugar. However, it's important to note that individual factors such as activity level, health history, and the duration of following a keto diet can also influence how exercise affects blood glucose trends.

Optimising Exercise for Blood Sugar Control

When following a keto diet, you can optimise your exercise routine to help manage blood sugar levels effectively. Here are some tips to consider:

• Exercise duration and frequency: Aim for 3-6 exercise sessions per week, with each session lasting between 30-60 minutes. This will help regulate blood sugar levels and promote overall health.
• Exercise intensity: If you're just starting to incorporate exercise into your routine, start with moderate-intensity exercises such as brisk walking, swimming, or light jogging. Gradually increase the intensity as you build your fitness level.
• Fuel your body: Ensure you're consuming enough carbohydrates to support your exercise routine. Aim for 3-5g of carbohydrates per kilo of body weight per day for 3-4 exercise sessions per week. If you're exercising more frequently or at a higher intensity, increase your carbohydrate intake to 5-8g per kilo of body weight per day.
• Timing of exercise: Try to exercise after a meal, preferably one that includes carbohydrates and protein. This will help stabilise your blood sugar levels during and after your workout.
• Monitor your blood sugar: Use a continuous glucose monitor (CGM) to track your blood sugar levels before, during, and after exercise. This will help you understand how your body responds to different types and intensities of exercise, allowing you to make any necessary adjustments to your routine or diet.
• Be mindful of over-exercising: While exercise is beneficial for blood sugar control, overdoing it can lead to hypoglycemia, especially if you're not adequately fuelling your body. Listen to your body and adjust your exercise routine as needed.

Benefits of Exercise for Keto Dieters

Incorporating exercise into your keto diet offers several advantages for blood sugar management:

• Enhanced blood sugar control: Exercise helps improve insulin sensitivity, which is crucial for stabilising blood sugar levels. This can be especially beneficial for individuals with type 2 diabetes or insulin resistance.
• Increased metabolic flexibility: Exercise, in combination with a keto diet, can enhance your body's ability to switch between using ketones and glucose for energy. This metabolic flexibility ensures your body can efficiently utilise different fuel sources, promoting stable blood sugar levels.
• Improved overall health: Exercise not only helps manage blood sugar but also contributes to weight loss, improved cardiovascular health, and reduced risk of chronic diseases such as heart disease and Alzheimer's.
• Personalised keto experience: By monitoring your blood sugar levels during exercise, you can fine-tune your keto diet to suit your unique needs. You can experiment with different carb sources, amounts, and timing to find what works best for your body and fitness goals.

In conclusion, exercise is a valuable tool for managing blood sugar levels, especially when following a keto diet. By understanding the relationship between blood sugar and exercise, you can design an exercise routine that complements your keto diet, optimises blood sugar control, and promotes overall health and well-being.

Glucose and ketone levels

Blood glucose, or blood sugar, is a primary marker for determining the risk of diabetes. The higher your blood sugar, the higher your risk factors. However, blood sugar is not just a marker for diabetes; as blood glucose levels rise, so does the risk for many other life-threatening conditions, most notably heart disease.

Ketogenic or "keto" diets have been around for years. A keto diet can be a great tool for enhancing metabolic flexibility, reducing insulin levels, managing glucose levels, preventing neurological diseases, and treating migraines.

When following a keto diet, most people focus on their ketone levels. Ketone levels are measured via one ketone body in the bloodstream, beta-hydroxybutyrate (BHB). However, focusing solely on ketone levels can be disadvantageous. This is because ketones and glucose go hand in hand, and monitoring your glucose may be more beneficial than just monitoring your ketones alone.

How a Ketogenic Diet Impacts Blood Glucose

When glucose availability drops so low that the body doesn’t have enough to use for energy, it enters a state called ketogenesis. In this state, ketone bodies are created from fatty acids and replace glucose as the body’s primary source of energy. As you can see, the relationship between ketones and glucose is inverse.

• Lower Glucose Trends: Carbohydrates have the most influence on glucose levels. So, if you are following a zero to very low-carbohydrate diet, your glucose levels will remain more steady. Individual glucose baselines will differ from person to person depending on health history, the length of time following a keto diet, and activity level. However, average glucose levels for keto dieters usually hover anywhere between 70–90 mg/dL.
• Elevated Fasting Glucose Levels: Elevated fasting glucose levels are a common trend that has been observed in individuals who have been following a keto diet for a prolonged amount of time. This trend, also known as "glucose sparing," appears to be a natural adaptation.
• High Glucose Spikes to Small Amounts of Carbs: Keto diets help to lower insulin levels. However, another common trend is slightly higher glucose responses to small amounts of carbohydrates. Individuals who follow a very low-carb diet may have lower insulin sensitivity compared to someone who consumes more carbs. Keto diets can lead to temporary physiological insulin resistance, where the body overreacts when carbs are introduced.

Continuous Glucose Monitoring (CGM)

Ketones and glucose are interconnected. Checking your glucose or ketone readings with a meter provides a snapshot of what is happening in the body at that exact moment. However, there is no device that measures ketones continuously.

A CGM, which monitors glucose continuously, will help cut through the noise and variables. The CGM gives real-time feedback on your diet and daily habits, providing precision and clarity into what is impacting your glucose levels, which may potentially be impacting your ketones.

Tips for Monitoring Glucose on a Keto Diet

• Test Your Carb Threshold: Once you are in a steady state of ketosis, you can start testing your carbohydrate boundaries. To do this, gradually increase your carbohydrate intake while monitoring your ketones and glucose values through your CGM at the same time each day.
• Test Your Trigger Foods: To test your trigger foods, record your pre-prandial (before eating) ketone and glucose value. The best time to test this would be in a fasted state or at least three hours after a meal. Next, eat your experimental food choice and record your postprandial (after eating) ketone and glucose values two hours after your meal.
• Test Your Protein Threshold: To find out if you are consuming too much protein at one meal, test your ketones and glucose in a fasted state and make a note of it. Then, eat a meal and make a note of how much protein is in that meal. If the protein amount is too high, you will typically see a gradual rise in glucose data through the CGM.

Optimal Blood Sugar Readings on Keto

According to the Mayo Clinic, a fasting blood sugar level under 100 milligrams per deciliter is healthy. Your blood sugar following food (even ingesting pure sugar) should not exceed 125 milligrams per deciliter, as this is a sign of prediabetes.

There is also something called the Glucose Ketone Index. This is how you figure out the correlation between your blood sugar and ketone levels. To calculate this, you will need a blood ketone monitor. Simply divide your blood glucose number (milligrams per deciliter) by 18, then divide that number by your ketone reading. A reading of nine or less is correlated with ketosis.

Factors that May Impact Blood Sugar Readings

Some of the things that can spike your blood sugar (and affect your reading) include:

• Certain non-caloric sweeteners
• Lack of exercise or activity

Additionally, there are a few things that can lower your blood sugar:

Alcohol

Frequently asked questions